Linkage Program Research Articles

Abstract P150: Linkage Program to Identify Siblings from a CARDIAC Risk Factor Registry

Introduction: The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project gathers anthropometric, BP and lipid data from fifth graders in West Virginia in the past 18 y. 60,403 children had LDL cholesterol and we found 5259 sets of siblings by direct match on mothers first and last name. The suggestion that more sibships could be identified prompted evaluation of Link Plus software from Centers for Disease Control (CDC) to improve matching. Methods: LinkPlus generates potential matches via a probabilistic algorithm that allows relative weighting of multiple factors such as first and last name. For our purposes the deduplication rather than matching algorithm was run using mother’s first and last name using the NYSIIS (New York State Identification and Intelligence System) phonetic schema to avoid creating multiple many-to-many relationships that were difficult to analyze. Additional variables considered included county, street address, telephone, fathers first and last name, school. Subject last name was used as a blocking variable. Results: 7602 matched siblings were generated by the program that determined a probability score ranging from 61.3 to cut off at 15; few matches were observed below this level. The figure demonstrates exponential decay beginning at a probability score of 26 with 95% accuracy at 25.5. 6827 pairs were included at that level including 6824 matched pairs and only 3 false positive pairs. Partial matches (n = 61) likely are half sibs including exact match of telephone and/or street but only one parent matching. Child surname was not used in the algorithm. Typographical errors were accounted by Link Plus. Lipid correlations were similar to those found with excel but more robust. Conclusion: The Link Plus record matching program from CDC is able to successfully determine sibships with increased sensitivity compared with a direct match from a sorted excel file. The program was able to identify likely sibs and half-sibs plus avoid non-match due to minor typo errors in the analyzed fields.

Transnational Associational Life and Political Mobilization of Ecuadorians and Argentines in Spain and Italy: What Role for Sending State Policies?

To what extent and how can sending states encourage migrant organizational efforts and transnational political engagements? This study addresses this question for the cases of Ecuadorians and Argentines in Spain and Italy. The findings show that both sending states have recently innovated, reaching out to citizens abroad through a similar combination of policy instruments: rhetorical changes, institutional developments, enfranchisement, and linkage programs. The scope, intensity, and results of outreach efforts differ not only across migrant communities but also localities, suggesting the need to explore factors such as domestic and intrastate politics, migrants’ socioeconomic and educational profile and perceptions of state institutions, spatial distance, and the type of private-public policy networks at migrant destinations. The conclusions indicate that states have been relatively effective in tapping into migrants’ symbolic and emotional attachments to the homeland, but they have obtained meager results in terms of grounding such attachment in strong organizations, persistent transnational political engagement, and partnership links. The modality of policy implementation resulted in a sporadic and “sentimental” political mobilization of both Ecuadorian and Argentine emigrant communities, which still confront serious organizational problems and remain far from working as strong influential groups at home or ethnic lobbies in receiving countries.

India’s policies on leveraging financial inclusion in the country

Exclusion of basic financial services acts as an obstacle in achieving economic development because financially excluded people are forced to take credit at exorbitant rates from informal sources which results in debt, unemployment and rise in crime rates (Sharma & Kaur 2012; Mathew & Kurian 2015). Moreover, lack of access to the financial services or the inability to use them leads to social exclusion (European social watch report 2010). Hence financial inclusion becomes a priority of every government. In India several policy initiatives have been taken by the Government of India (GOI) and Reserve Bank of India (RBI) to make banking services accessible to the masses; right from nationalization of banks to priority sector lending to launching of lead bank scheme to establishing Regional Rural Banks to initiating Self – Help group bank Linkage Programme. In spite of all the sincere efforts by Government of India (GOI) and by Reserve Bank of India (RBI), they are yet to overcome several hurdles as 10.91% of the entire population in the country state distance as a barrier, 10.92% of them state cost as a barrier, 9.71% report documentation as a barrier and 3.47% report trust as a barrier for opening a bank account (World Bank 2016). In this paper through expository research we have made an attempt to study the various initiatives taken by the authoritative bodies in India to achieve financial inclusion and its impact on the households. A thorough study has been done on the various policies undertaken and the participation of the various stakeholders of the Indian economy to help in the successful execution of these policies. Data has been gathered through official reports published by these authoritative bodies and an analysis of the parameters that indicate the spread of financial inclusion has been undertaken.

Impact of Financial Awareness on Financial Inclusion of Members of Self Help Groups: A Study in Tripura

The banking sector saw major reforms as a step towards financial inclusion with the nationalization of banks to increase the outreach of state controlled formal financial system among the people particularly the rural and low income people. Inspite of expansion of bank branches a significant number of rural population still remains outside the formal banking system. Self help group bank linkage program started as a pilot project by NABARD in 1992 is another attempt to provide access to low cost financial services to the members of the self help groups. Considering awareness of financial product as a significant factor for taking financial decision leading to use of financial services, this paper explores the relationship between financial awareness and its impact on financial inclusion. Primary data were collected through a structured questionnaire from 384 members belonging from 78 self help groups registered in the state of Tripura under the flagship program run by National Rural Livelihood Mission. The paper is divided into three parts; in the first part it deals with the identification of level of financial inclusion and the second part identifies the level of financial awareness. The third part explains the impact of financial awareness on the level of financial inclusion. The study reveals that financial awareness is an significant factor affecting financial inclusion of the sample members. The self help group members having high level of financial awareness are more financially included in the formal banking system with the high use of variuos banking and financial products that are available at their disposal. The study also emphasis on conducting of financial literacy camps to enhance the decision making ability of the members giving them oppurtunity to use formal financial services and reduce their dependence on informal source.

A Review of Self Help Bank Linkage Programme in Krishna District: Andhra Pradesh

A Review of Self Help Bank Linkage Programme in Krishna District: Andhra Pradesh

Self Help Group Bank Linkage Programme- An Index of Measuring Financial Inclusion

Background/Objectives: In India the largest population falls under rural category. People from rural areas have experiences several issues for getting banking services to meet their basic requirements. To manage these challenges Self Help Group were formed consisting of 10 to 20 members in a group with a very low income and residing in unreached segments in our society. The major objective for forming the group is to get an access on financial services at an affordable cost. The members existing in these groups save their money which is utilized for loans. Even if there are several ways to fulfill the objectives of financial inclusion, Self Help Group Bank Linkage Programme is named to be an esteemed platform to meet the expectations of banking services among poor people. Therefore this paper has done an investigation on facilitating banking services to the poor people from the members of self help groups in the various districts of Tamil Nadu, India. Methodology: The study has measured an Index of Financial Inclusion using Multidimensional approach by considering three different dimensions such as Bank Penetration, Credit Penetration and Penetration of Self Help Groups in various districts of Tamil Nadu. Findings: The Districts were ranked based on the Index Scores generated through various parameters and the level of financial inclusion among various districts has been highlighted in the study. Novelty: When considering the banking services facilitated to Self Help Groups many districts in Tamil Nadu have very low level of financial inclusion. Out of all the models designed by our government, Self Help Group Bank Linkage Model is said to be the Successful model which are acceptable by the poor people. Therefore to revamp the status of financial inclusion, the Government of India and concern banking authorities should consider the members of self help groups for obtaining credit facilities in order to satisfy their basic requirements.

The California Linkages Program: Doorway to Housing Support for Child Welfare-Involved Parents.

Housing instability can complicate parents' efforts to provide for their children. Child welfare service agencies have had difficulty adequately serving parents' housing needs due to limited and constrained funding streams. This article integrates the voices of four important stakeholders to illuminate how an innovative model of service system coordination called Linkages addresses housing needs for child welfare-involved parents eligible for public assistance. Facilitated by Linkages, these parents can receive supportive housing services through programs affiliated with the California public assistance program CalWORKs. Personal narratives reflecting the diverse perspectives of stakeholders in the Linkages collaboration-the statewide program director, a child welfare services coordinator, a CalWORKs caseworker, and a parent program participant-shed light on how the collaboration assists parents in attaining case plan goals, and highlights some of the factors facilitating and hindering effective collaboration between the agencies involved. Stakeholders emphasized the value of flexible service approaches, the intensity of the efforts required, the role of advocacy, and the importance of a shared vision between agencies working together to provide housing supports.

Economic Sustainability for Islamic Nanofinance through Waqf - Sukuk Linkage Program : Case Study in Indonesia

This paper argues that sukuk potentially to be an Islamic nanofinance instrument for mobilizing fund to the very micro society. Further, collaboration sukuk and waqf can be an innovation for economic sustainability, particular to get low cost fund to finance the very micro society without interest rate. Hence, this paper attempts to: (1) Introduce nanofinance of microfinance institutions in Indonesia; (2) Introduce cooperative sukuk as a local wisdom of microfinance institution in Indonesia to finance the real sector; (3) Propose model of waqf-sukuk linkage program for nanofinance by synergizing Islamic banks, waqf institutions and microfinance institutions to encourage Islamic financial inclusion for the very micro society.

Supporting continuity of care between prison and the community for women in prison: a medical record review.

Objectives The aim of the present study was to examine health information transfer and continuity of care arrangements between prison and community health care providers (HCPs) for women in prison. Methods Medical records of women released from New South Wales prisons in 2013-14 were reviewed. Variables included health status, health care in prison and documented continuity of care arrangements, including information transfer between prison and community. Associations were measured by adjusted odds ratios (AORs) using a logistic regression model. Text from the records was collected as qualitative data and analysed to provide explanatory detail. Results In all, 212 medical records were systematically sampled and reviewed. On prison entry, information was requested from community HCPs in 53% of cases, mainly from general practitioners (GPs, 39%), and was more likely to have occurred for those on medication (AOR 7.08; 95% confidence interval (CI) 3.71, 13.50) or with schizophrenia or other psychotic disorders (AOR 4.20; 95% CI 1.46, 12.11). At release, continuity of care arrangements and health information transfer to GPs were usually linked to formal pre-release healthcare linkage programs. Outside these programs, only 20% of records had evidence of such continuity of care at release, with the odds higher for those on medication (AOR 8.28; 95% CI 1.85, 37.04) and lower for women with problematic substance misuse (AOR 0.32; 95% CI 0.14, 0.72). Few requests for information were received after individuals had been released from custody (5/212; two from GPs). Conclusion Increased health information transfer to community HCPs is needed to improve continuity of care between prison and community. What is known about the topic? Many women in prison have high health needs. Health and well being are at further risk at the time of transition between prison and community. What does this paper add? This study provides evidence that outside formal programs, which are currently available only for a minority of women, continuity of care arrangements and transfer of health information do not usually occur when women leave prison. Pragmatic choices about continuity of care at the interface between prison and community may have been made, particularly focusing on medication continuity. Barriers to continuity of care and ways forward are suggested. What are the implications for practitioners? Siloing of health care delivered within prison health services through lack of continuity of care at release is wasteful, both in terms of healthcare costs and lost opportunities to achieve health outcomes in a vulnerable population with high health needs. There is need for an increased focus on continuity of care between prison and community health services, HCP support and training and expansion of pre-release planning and healthcare linkage programs to assist larger numbers of women in prison.

First Source Hiring: An Essential Tool for Linking the Poor to Employment or a “Dead Letter” Progressive Policy?

Although cities have revived as economic centers for the middle and upper classes, poor and minority communities continue to be locked out of urban job markets. First Source Hiring is designed to act as both a linkage program and a targeted hiring rule to ensure low-income residents have opportunities to work on publicly sponsored projects. A first wave of FSH began in the 1980s but was abandoned due to political push-back. A second wave emerged in response to growing inequality in the 1990s and 2000s. In this article, we review the literature on FSH development and implementation through a Four Rs evaluation framework. Then, we use case studies of FSH for Los Angeles World Airports, the Atlanta BeltLine, and the City of San Francisco to assess the potential of “second-wave” FSH programs to make meaningful contributions to linking disadvantaged job seekers with opportunities.

Success of Self Help Group – Bank Linkage Program in India under Financial Inclusion

The ‘social banking’ policies being followed by the country resulted in widening the geographical spread and functional reach of commercial banks in rural areas in the period that followed the nationalization of banks. This paper is concluded with a view that SHG – Bank Linkage program is a success in our country India and helping many people to make their life better.

Study on Micro Financing: Need for Innovation

Micro finance means providing very poor families with very small loans (micro credit) to help them engage in productive activities/small businesses. Micro Finance can contribute to the financial inclusion of the poor without which it will be difficult for them to come out of the vicious cycle of poverty. to strengthen all the available channels of providing credit to the poor such as SHG- Bank Linkage programmes, Micro Finance Institutions, Cooperative Banks, State financial corporations, Regional Rural Banks and Primary Agricultural Credit Societies. The strength of the micro finance industry lies in its informality and extremely It is required flexibility which should be protected and encouraged.

Primary Care Continuity Improves Diabetic Health Outcomes: From Free Clinics to Federally Qualified Health Centers.

There are a number of well-established barriers to accessing primary care. The LINKED Study set out to improve primary care usage through 1-on-1 counseling and referrals for patients with diabetes being treated at local free clinics. We hypothesized that this educational intervention paired with expedited referral would increase the use of federally qualified health centers (FQHCs) as a source of health care and ultimately lead to improved diabetic health. Medical student volunteers counseled participants on the importance of primary care. The participants then completed surveys about diabetic health, socioeconomic status, and general demographics. Participants were subsequently assigned to 1 of 2 FQHCs; designated care coordinators facilitated appointments. At the end of a 9-month action period, participants repeated the initial surveys, now including appointment history and health data (hemoglobin A1c (%) [HbA1c], body mass index). Sixty-eight participants were enrolled. The average time since a diagnosis of diabetes mellitus was 8.3 years (standard deviation [SD], 8.4 years), and 25% of participants used insulin. Mean baseline HbA1c for participants with a recorded value (n = 55) was 9.5 (SD, 2.5). FQHC appointments were scheduled by 68% of participants; 38% of the participants attended ≥2 appointments. The most common reported barriers to accessing primary care were no prior health insurance (85.3%) and cost of medical care (72.1%). In our follow-up assessment there was a statistically significant decrease in HbA1c for those linked to FQHCs (9.5 [SD, 2.3] to 8.3 [SD, 2.2]; n = 21). This study demonstrates the utility of a linkage program from free clinics to FQHCs. Those individuals with diabetes receiving health care from an FQHC demonstrated improved glycemic control.

Can TasP Approaches Be Implemented in Correctional Settings?: A review of HIV testing and linkage to community HIV treatment programs.

High rates of HIV in correctional populations makes evaluation of programs that increase HIV testing in correctional settings and linkage to HIV treatment upon release, and understanding key implementation issues of these programs, essential to reducing new HIV infection. We conducted a systematic search for studies of outcomes or implementation issues of programs that promote HIV testing or that promote linkage to community HIV treatment post-release. Thirty-five articles met inclusion criteria: nine HIV testing initiatives and four linkage programs. HIV testing uptake rates were between 22% and 98% and rates of linkage to community treatment were between 79% and 84%. Findings suggest that some programs may be effective at reducing HIV transmission within the communities to which inmates return. However, attention to implementation factors, such as organizational culture and staff collaborations, appears critical to the success of these programs. Future research using rigorous design and adequate comparison groups is needed.

Determinants of participation in self-help-groups (SHG) and its impact on women empowerment

Purpose The purpose of this study is to gain meaningful insights into a microfinance programme in two different agro-ecological settings in India. The study, using primary survey data, attempts to examine individual, household and environmental characteristics that determine participation in a self-help group (SHG)–bank linkage programme in Odisha. Design/methodology/approach Primary data are collected by a stratified random sampling method. The sample size is 300 households and information is collected by canvassing a pre-designed schedule to women through door-to-door in-depth interviews. In addition, focus group discussions have been conducted to get qualitative information. A probit binary model is applied to examine the factors determining participation in a SHG–bank linkage programme. A composite index of women empowerment is computed taking three dimensions: autonomy, economic empowerment and the gender relationship. Further, ordinary least square multiple regression and treatment effect evaluation by propensity score matching is carried out to study the impact of participation on women empowerment. Findings The study finds that the programme has by-passed the poorest of the poor. It is observed, however, that participation in microfinance has a positive and significant impact on women empowerment. Research limitations/implications Given the research methodology adopted in this study, one concern is whether the results generalise. Therefore, researchers are encouraged to test the proposed propositions further. Practical implications To improve status of women particularly in developing and underdeveloped regions, microfinance can act as a catalyst. Social implications Microfinance in the form of SHG–bank linkage should be promoted, particularly for those social groups and religious communities where women are discriminated. Their participation in SHG–bank linkage programme will improve their social status through empowerment. Originality/value This study illustrates how microfinance can improve the status of women.

HIV Testing, Care Referral, and Linkage to Care Intervals Affect Time to Engagement in Care for Newly Diagnosed HIV-Infected Adolescents in 15 Adolescent Medicine Clinics in the United States

To examine how the time from HIV testing to care referral and from referral to care linkage influenced time to care engagement for newly diagnosed HIV-infected adolescents. We evaluated the Care Initiative, a care linkage and engagement program for HIV-infected adolescents in 15 US clinics. We analyzed client-level factors, provider type, and intervals from HIV testing to care referral and from referral to care linkage as predictors of care engagement. Engagement was defined as a second HIV-related medical visit within 16 weeks of initial HIV-related medical visit (linkage). At 32 months, 2143 youth had been referred. Of these, 866 were linked to care through the Care Initiative within 42 days and thus eligible for study inclusion. Of the linked youth, 90.8% were ultimately engaged in care. Time from HIV testing to referral (eg, ≤7 days versus >365 days) was associated with engagement [adjusted odds ratio = 2.91; 95% confidence interval (CI): 1.43 to 5.94] and shorter time to engagement (adjusted hazard ratio = 1.41; 95% CI: 1.11 to 1.79). Individuals with shorter care referral to linkage intervals (eg, ≤7 days versus 22-42 days) engaged in care faster (adjusted hazard ratio = 2.90; 95% CI: 2.34 to 3.60) and more successfully (adjusted odds ratio = 2.01; 95% CI: 1.04 to 3.89). These data address a critical piece of the care continuum and can offer suggestions of where and with whom to intervene to best achieve the care engagement goals outlined in the US National HIV/AIDS Strategy. These results may also inform programs and policies that set concrete milestones and strategies for optimal care linkage timing for newly diagnosed adolescents.

Collaborative and Linkage Programs Between TVET Institutions and the Industry. A Case of TVET Institutions in North Rift Region, Kenya.

The industry-institute relationship as a result of industrial attachment program among TVET institutions plays a key role in ensuring up to date skill transfer among TVET graduates. This paper highlights the various forms of collaboration between TVET institutions and Industry in Kenya through an industrial attachment program. The study focused on TVET institutions in North Rift region, Kenya. The study adopted descriptive survey design. Stratified proportionate simple random sampling technique was used to select a sample of 245 respondents which included 30 lecturers, 3 industrial liaison officers, 5 workplace supervisors and 207 TVET students. The research instruments for data collection were; the structured questionnaire and interview schedule. Data was analyzed using descriptive statistics. Descriptive statistics included frequencies, percentages and mean. Data was presented in form of pie charts, bar charts, and tables. The study recommends that training institutions need to strengthen institute-industry linkage to ensure quality training.

Establishing a process for conducting cross‐jurisdictional record linkage in Australia

Objective:To describe the realities of conducting a cross‐jurisdictional data linkage project involving state and Australian Government‐based data collections to inform future national data linkage programs of work. Methods:We outline the processes involved in conducting a Proof of Concept data linkage project including the implementation of national data integration principles, data custodian and ethical approval requirements, and establishment of data flows. Results:The approval process involved nine approval and regulatory bodies and took more than two years. Data will be linked across 12 datasets involving three data linkage centres. A framework was established to allow data to flow between these centres while maintaining the separation principle that serves to protect the privacy of the individual. Conclusions:This will be the first project to link child immunisation records from an Australian Government dataset to other administrative health datasets for a population cohort covering 2 million births in two Australian states. Implications:Although the project experienced some delays, positive outcomes were realised, primarily the development of strong collaborations across key stakeholder groups including community engagement. We have identified several recommendations and enhancements to this now established framework to further streamline the process for data linkage studies involving Australian Government data.

CD4 Counts at Entry to HIV Care in Mexico for Patients under the "Universal Antiretroviral Treatment Program for the Uninsured Population," 2007-2014.

In Mexico, public health services have provided universal access to antiretroviral therapy (ART) since 2004. For individuals receiving HIV care in public healthcare facilities, the data are limited regarding CD4 T-lymphocyte counts (CD4e) at the time of entry into care. Relevant population-based estimates of CD4e are needed to inform strategies to maximize the impact of Mexico’s national ART program, and may be applicable to other countries implementing universal HIV treatment programs. For this study, we retrospectively analyzed the CD4e of persons living with HIV and receiving care at state public health facilities from 2007 to 2014, comparing CD4e by demographic characteristics and the marginalization index of the state where treatment was provided, and assessing trends in CD4e over time. Our sample included 66,947 individuals who entered into HIV care between 2007 and 2014, of whom 79% were male. During the study period, the male-to-female ratio increased from 3.0 to 4.3, reflecting the country's HIV epidemic; the median age at entry decreased from 34 years to 32 years. Overall, 48.6% of individuals entered care with a CD4≤200 cells/μl, ranging from 42.2% in states with a very low marginalization index to 52.8% in states with a high marginalization index, and from 38.9% among individuals aged 18–29 to 56.5% among those older than 50. The adjusted geometric mean (95% confidence interval) CD4e increased among males from 135 (131,142) cells/μl in 2007 to 148 (143,155) cells/μl in 2014 (p-value<0.0001); no change was observed among women, with a geometric mean of 178 (171,186) and 171 (165,183) in 2007 and 2014, respectively. There have been important gains in access to HIV care and treatment; however, late entry into care remains an important barrier in achieving optimal outcomes of ART in Mexico. The geographic, socioeconomic, and demographic differences observed reflect important inequities in timely access to HIV prevention, care, and treatment services, and highlight the need to develop contextual and culturally appropriate prevention and HIV testing strategies and linkage programs.

Micro Financing Through Women Self-Help Groups and its Socio-Economic Impact- A Case Study of Konkan Region of Maharastra

Micro finance programmes have been receiving a considerable attention world over for their potential to generate income and employment and alleviate poverty. The experience shows that the micro finance programme has a high degree of out reach to women i.e. 82.67 per cent of the aggregate clients in India in 2010, 73 per cent in Latin America, 70 percent in Africa and 88 percent in Asia. In India, National Bank for Agriculture and Rural Development (NABARD) sponsored SHG-Bank linkage programme is the fastly growing micro finance programme in the world covering 97 million poor households as on 31st March, 2011.The research paper was focused to find out whether micro finance really contributed to the socioeconomic empowerment of group members? To what extent, micro financing through women groups benefited the members? Out of 350 Women groups promoted by Sadbhav Foundation (33 groups), Raigarh district, Manav Sadhan Vikas (25 groups), Kudal, Sindhudurga district and Matru Mandir (19 groups), Ratnagiri district (Maharashtra state, India) 77 (22 percent) were selected. Two members from each group (i.e.154 members) were selected deliberately. After joining the groups, the monthly average income and savings of the respondents had shown increase by 133.73 percent and 76.27 percent respectively. The confidence level of the respondents had increased to a great extent. They had reported active participation in socioeconomic activities. Overall personality index had shown growth of 59.01 percent. It was inferred that micro financing through women self help groups had brought a positive change in the lives of the members. The study concluded that poor, discriminated and underprivileged women if join the groups, can come out of poverty.